The usual cleaning practice protocol for open wounds includes wiping with gauze pads soaked in irrigation solution starting in the center of the wound and working toward the outside.1 No particular attention is paid to the periphery of the wound, and the suggested technique may relocate debris and bacteria from the center to the creases of the wound periphery.

With this 56-year-old patient, cleaning was typically focused on the center of the wound, as shown in Figure 1. By incorporating the MolecuLight i:X (in Fluorescence Imaging ModeTM) into the cleaning protocol, the practitioner was able to visualize moderate/heavy bacterial load in the creases and at the periphery of the wound (Figure 2 & Video A) in real-time. She therefore focused on cleaning those edges and creases (Video B) and used MolecuLight i:X images to instruct the home caregiver (patient’s husband) on where to focus cleaning.

After two weeks of cleaning every 2-3 days with the guidance of the MolecuLight i:X, there was a remarkable decrease in red (bacterial) fluorescence at the periphery of the wound (Figure 4). Furthermore, the wound bed began to granulate with the successful use of a Negative Pressure Wound Therapy (NWPT) device, which had previously failed with this patient.

Figure 3: ST-imageTM. Image taken under standard lighting conditions after 2 weeks of treatment guided by MolecuLight i:X.Figure 4: FL-imageTM. Image taken with MolecuLight i:X in Fluorescence Imaging ModeTM after 2 weeks of treatment. The absence of red color indicates that the wound no longer contains moderate/heavy levels of bacteria.

See How the MolecuLight i:X Guides Wound Cleaning

Video A: ST-videoTM and FL-videoTM. Video taken under standard lighting conditions then in Fluorescence Imaging Mode to screen for the presence of bacteria. In Fluorescence Imaging Mode, the red color indicates moderate/heavy levels of bacteria in the wound periphery and adjacent creases.

Video B: FL-video. Video taken in Fluorescence Imaging Mode during cleaning which shows the removal of bacteria (red color) from the creases (and onto the gauze).

Rose Raizman RN-EC, MSc, with over 19 years of experience, leads the Save Our Skin (SOS) team at Scarborough & Rouge Hospital located in Toronto, Canada, to combat pressure ulcers of hospital inpatients. She also oversees the wound care clinic for inpatients and outpatients.